目的 评估含米诺环素的四联疗法相较于传统四联疗法治疗幽门螺杆菌（Helicobacter pylori， H.pylori）的有效性、安全性及患者依从性。 方法 纳入200例H.pylori阳性患者，含米诺环素的铋剂四联组（LBMC组）和含阿莫西林的铋剂四联组（LBAC组）各100例，采用倾向性得分匹配法（propensity score matching， PSM）对两组患者进行匹配后每组各86例，治疗开始后第14天实施电话随访，记录患者的用药依从性及出现的药物不良反应。在完成治疗方案并停止用药至少1月后进行¹³C尿素呼气试验复查。数据分析采用ITT和PP对比两组间的H.pylori根除率。 结果 LBMC组和LBAC组在ITT分析中的根除率分别为89.5%（77/86，95%CI：82.9% ~ 96.1%）、82.6%（71/86，95%CI：74.4% ~ 90.7%）；在PP分析中，根除率分别为92.6%（75/81，95%CI：86.8% ~ 98.4%）、88.8%（71/80，95%CI：81.7% ~ 95.8%）。LBMC组不良反应发生率为27.9%（24/86），LBAC组为31.4%（27/86），两组不良反应率差异无统计学意义（P > 0.05），在依从性方面，LBMC组94.2%（81/86），LBAC组93.0%（80/86），两组患者的依从性差异无统计学意义（P > 0.05）。 结论 作为根除H.pylori的一线方案，含米诺环素的方案根除效果不逊于含阿莫西林的方案，安全性和依从性相似，可作为青霉素过敏患者的替代治疗方案。

Objective To evaluate the efficacy， safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter （H.） pylori. Methods This study included 200 H.pylori positive patients， with 100 assigned to the minocycline-containing bismuth quadruple therapy group （LBMC group） and the other 100 to the amoxicillin-containing bismuth quadruple therapy group （LBAC group）. After matching the two groups of patients using the propensity score matching （PSM） method，there were 86 cases in each group. Telephone follow-up was conducted on the 14^th day after the start of treatment to record patient medication compliance and adverse drug reactions. A ¹³C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat （ITT） and per-protocol （PP） analyses were used to compare the H.pylori eradication rates between the two groups， and Chi-square test and t-test were used for intergroup comparison. Results In the ITT analysis， the eradication rates of the LBMC group and the LBAC group were 89.5% （77/86， 95%CI： 82.9% ~ 96.1%） and 82.6% （71/86， 95%CI： 74.4% ~ 90.7%）， respectively. In the PP analysis，the eradication rates were 92.6% （75/81， 95%CI： 86.8% ~ 98.4%） and 88.8% （71/80， 95%CI： 81.7% ~ 95.8%）， respectively. The adverse reaction rate of the LBMC group was 27.9% （24/86）， and that of the LBAC group 31.4% （27/86）， showing no statistically significant difference （P > 0.05）. In terms of compliance， the LBMC group was 94.2% （81/86）， and the LBAC group 93.0% （80/86）， revealing no statistically significant difference （P > 0.05）. Conclusion As a first-line treatment for eradicating H.pylori， regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin， with similar safety and compliance. They can be used as an alternative treatment for patients allergic to penicillin.